Individual
DANIELLE NYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5044 CYPRESS TRACE DR, TAMPA, FL 33624-6910
(813) 924-5276
Mailing address
5044 CYPRESS TRACE DR, TAMPA, FL 33624-6910
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT18989
FL
Other
Enumeration date
02/19/2018
Last updated
02/19/2018
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